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General NPI Number Information
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NPI Number | 1083281901
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Entity Type | Organization
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Legal Business Name | TKS PROFESSIONAL SERVICES, LLC
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 1300 DIAMOND SPRINGS RD STE 401
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455
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Country | US
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Telephone | 757-585-4033
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 ELLSWOOD CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23453-5926
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Country | US
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Telephone | 757-477-7141
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Fax |
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | CHERRA BARBOUR-SMITH
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Credential | LPC
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Telephone | 757-585-4033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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